Provider Demographics
NPI:1437194602
Name:SANTINI, JOSE GUILLERMO (OD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:GUILLERMO
Last Name:SANTINI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 12
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794
Mailing Address - Country:US
Mailing Address - Phone:787-857-1437
Mailing Address - Fax:787-857-1437
Practice Address - Street 1:URB. GREEN HILLS
Practice Address - Street 2:CARR.#3 ESQ. CALLE GIRASOL, EDIF. 6
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-866-1231
Practice Address - Fax:787-866-1231
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR347152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRV09029Medicare ID - Type Unspecified
PR077125Medicare UPIN
PR2200049Medicare UPIN
PR57513Medicare UPIN